| Objectives: Vertigo and dizziness are among the 20 most common causes of consultation in adult patients.In 80% of these cases,the symptoms are so intense as to require medical intervention.Patients with vertigo and dizziness always involved in orthopaedic,otolaryngology,neurology and other departments,sometimes the diagnosis need to collaborate among these departments.There are a various causes of vertigo including those arising from disturbances of the ear,nose,and throat;central nervous system;cardiovascular system;and benign positional paroxysmal vertigo.The problem of a group of patients is a disorder of the cervical spine,known as cervical vertigo.These are three theories commonly proposed mechanisms for cervical vertigo:Barre-Lieou syndrome(sympatheticcervical syndrome),Proprioceptive cervical vertigo and Vertigo in rotational vertebral artery syndrome(bow-hunter syndrome).There is no specific test to rule in cervical vertigo.The diagnosis of cervical vertigo must be combined with history,physical examination,image examination and other potential causes for dizziness or vertigo have been excluded.Patients with cervical vertigo often have dysfunction of autonomic nerve and heart rate variability reflects the activity of autonomic nervous system.So the objective of this program reflects the state of autonomic nerve by heart HRV and investigate the short term HRV of patients with vertigo to explore the relation between cervical and autonomic nervous system.Conservative treatment is the main method for the patients with cervical vertigo,but need to combine with various schemes.This article sets on the conservative treatment according to the characteristics of the patients with cervical vertigo and investigates the short-term efficacy.1 From January 2016 to December 2016,12 patients met the inclusion criteria come to the department of orthopaedic in the Bethune International Peace Hospital and 18 patients conform to criteria of normal control group.HRV measurements were performed under standard conditions(at least 3hrs after breakfast,12-hrs cessation of smoking,consumption of coffee,tea,between 9–to 12 a.m.in a quiet room,temperature23-26.The ECG signal was processed by a record system Holter from5-minute period recordings after the neck remain upright following the10-minute comfortable sitting position.The Holter records 5-minute period of ECG signal in the neck stand upright after the patients repeated continue hyperextension and hyperflexion 30 times.This process would be ceased if the patients feel vertigo,dizziness or aggravated.The recorded ECG signal will be imported to American H-Scribe Holter system which matches to the recorder in order to investigate the HRV.It is necessary to remove the interference factors of Superventricular premature beat and premature beat before investigating.Compare the HRV between the cervical group and normal group while investigate the change of the HRV before and after repeating the hyperextension and hyperflexion.2 From January 2016 to December 2016,totally 20 patients were diagnosed as cervical vertigo,who showed good adherence in this study.They were received the conservative therapy 1 month with cervical collar fixed and neck muscle exercises.They should fill out the DHI and VAS before and after the treatment.Compare the difference of the score before and after treatment and evaluate the efficacy.Results:1 LF/HF after stimulus in the cervical vertigo group showed significant higher(P<0.05)than at rest.Compare the normal group,the cervical vertigo group showed significant higher in terms of LF/HF(P<0.05)after stimulus.2 Eighteen patients(90%)of cervical vertigo experienced complete remission or showed clinical improvement after the one-month conservative therapy and none of them with worsening symptom.The score of DHI and Methods:VAS showed significant lower value after treatment(P<0.05).Among the patients received conservative therapy,2 patients(10%)were assessed as good,12(60%)as fair and 4(20%)as fine,2(10%)as bad(good and fair 70%).Conclusions:1 The balance between sympathetic nervous system and parasympathetic nervous system is disturbed after the cervical hyperextension and hyperflexion on cervical vertigo patients,it is one of the causes of cervical vertigo.2 HRV is a simple tool to reflect sympathetic nervous system and parasympathetic nervous system,should be used wildly.3 The strength of neck muscle can strengthen the stability of the cervical vertebra,in that will be the prevention and treatment of cervical vertigo.4 Improved the stability of the cervical vertebra can maintain the balance of the sympathetic nervous system and parasympathetic nervous system,and will be the prevention and treatment of cervical vertigo.5 Cervical collar fixed and neck muscle exercises(“xiao fei yan”)can significantly improve symptoms and consolidate the clinical effect of cervical vertigo. |
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